Prof. stated that the risk of rabies transmission from dogs is much higher than from cats. Dr. Bülent Ertuğrul stated that cats are not one of the main host animals that constantly carry the virus.
"Cats only get the virus by chance when they encounter animals such as a rabid dog, fox or hyena in nature or on the street. During the fight, cats largely lose their lives. This reduces the possibility of transmitting the virus even if it gets it," said Ertuğrul, adding:
"On the other hand, cat-borne rabies cases are included in the literature. No cat-borne rabies case has been detected in Turkey in the last 20 years. At least it has not been found so far. According to the records of the Ministry of Health in Turkey, all of the more than 20 rabies cases detected in the last 10-15 years developed after dog contact."
The fact that the risk of rabies transmission from cats is very low does not mean that it will not happen. For this reason, when you are bitten or scratched by a stray cat, do not take any risks and get vaccinated. There is no harm in the vaccine, on the contrary, if you get vaccinated, you eliminate all risks and save your life.
Prof. Dr. Bulent Ertuğrul
Prof. stated that it is known that rabies is generally transmitted through saliva contact, but scratching in cats also carries a risk. Dr. Ertuğrul drew attention to cats' habit of licking their paws. Ertuğrul stated that the virus can also be transmitted through scratching, as cats get their saliva on their paws, but stated that the transmission is unlikely.
"Because the rabies virus is an 'enveloped' virus, it dies immediately when exposed to the external environment and sunlight. In order for transmission to occur through scratching, a very precise timing must coincide, such as a rabid cat licking its paw and then immediately scratching a person without wasting any time. Therefore, transmission from a cat is difficult but not impossible."
Ertuğrul also added that most of the suspected post-exposure vaccinations in Türkiye were caused by cat bites or scratches.
Stating that the first and most critical step to be taken in case of suspicious contact is to wash the area with plenty of soapy water, Ertuğrul said that soap is the most basic substance that melts and dissolves the envelope outside the virus. Stating that washing with soap significantly reduces the virus load and will relax the person, the expert emphasized that this process alone does not eliminate the necessity of vaccination, and that a health institution should be consulted after washing.
Stating that new generation recombinant DNA vaccines are used in the rabies vaccination program, Prof. Dr. Ertuğrul said that the vaccination process is applied in four doses on days 0, 3, 7 and 14.
Stating that the contacted animal should be kept under observation for 10 days, Ertuğrul stated that there is no need for the fourth dose if the animal does not die of rabies or any other reason during this 10-day period. He stated that in cases where the animal cannot be tracked or is lost, the vaccination schedule is completed completely and this vaccination protocol protects the person for approximately 2 years.
Ertuğrul emphasized that only vaccination is not enough for serious and deep injuries, and rabies antiserum (hyperimmunoglobulin) should also be applied in case the virus can be hidden in muscle cells.
It was confusing when rabies symptoms appeared in a four-year-old girl in Diyarbakır four months later. We asked Prof. whether the incubation period would be this long. Dr. Ertuğrul gave striking information about the incubation period of rabies.
"The typical incubation period varies between 20 and 90 days, but this period may be longer depending on how long the virus multiplies in the muscle tissue. In the medical literature, there is a case of people experiencing rabies symptoms nine years after contact. There is even a case that appeared 27 years later," said Ertuğrul and added:
"The location of the wound, its depth, the amount of bleeding and its proximity to the nerve endings directly affect the incubation period. In bites that occur in areas such as the face and neck close to the brain, the incubation period can be reduced to four days."
Stating that the clinical symptoms of rabies occur in two different forms, 'calm' and 'aggressive', Prof. Dr. Ertuğrul said, "In the calm form, the patient becomes withdrawn and is disturbed by light and noise. In the aggressive form, severe seizures and aggression develop with external stimuli. After the virus reaches the nerves and creates encephalitis (brain inflammation) in the brain, the disease becomes 100% fatal. Only one case has been reported in the world that survived after the symptoms appeared. For this reason, it is necessary to start the vaccination program within the first 24 hours without waiting for the symptoms."
Jeanna Giese, who was bitten by a bat in the US state of Wisconsin in 2004 when she was 15 years old, contracted rabies, which is 100% fatal, because she missed the vaccine incubation period. However, his doctor, Dr. He made history as the first person in the world to defeat rabies without vaccination, thanks to the 'Milwaukee Protocol' developed by Rodney Willoughby, which aims to give the immune system time by putting the patient into an artificial coma. Giese, who spent two weeks in a coma and learned to walk and talk again after a long treatment in the hospital and a two-year rehabilitation process, continues his life today despite having nerve damage; Since this method has not achieved similar success in other patients, it continues to be discussed in the medical world in terms of ethics and reliability.
Prof. also clarified which animals carry the risk of rabies. Dr. Ertugrul; He stated that there is no risk of rabies in rodents such as mice and rats, because a mouse dies after encountering a rabid animal before it has time to carry the virus to a human. Stating that there is no risk in poultry, Ertuğrul said; He added that farm animals such as horses and wild creatures such as foxes and jackals carry the risk of transmitting the virus.
Referring to the discussions regarding stray animals, Prof. Dr. Bülent Ertuğrul stated that rabies was taken under control by leaving vaccine-containing feeds even to wildlife in forests in Europe. He said, "Vaccinating stray animals by municipalities at regular intervals and allocating budget and time for this will be the only humane and scientific method."
